A Medicaid Success Story...

Clarissa was born with a series of medical conditions so severe that when they manifested at age 19 she qualified for federal disability assistance.  “Despite all the health challenges I have faced, I have always been determined to live a full life and become a productive member of my community,” says Clarissa. Qualifying for the state’s Medicaid program opened the doors she needed to be successful. 

Prescription drug coverage helped her afford the necessary medications.  She was supposed to be in a wheelchair by age 30.  Thanks to physical therapy, Clarissa is still walking at age 32.  Physical therapy also helped her regain the use of her wrist after an intensive surgery.  Successfully managing her health allowed her to work part-time, go to school full-time and volunteer regularly.   

“Without access to Medicaid, I never would have been able to go to school.  Without my bachelor’s degree, I never would have been hired at my job, which has full health benefits.”  Clarissa is now privately insured through her employer.  She works full-time, goes to school full-time for her Master’s Degree and is completing an internship.  “Medicaid helped me when I needed it most: now I’m living a full and amazing life,” explains Clarissa. 

The Legislature should take great care as they look to shave dollars from Utah Medicaid.  Medicaid delivers quality, medically necessary care at the right price for all payers—including the taxpayer.  It is also a powerful economic driver for our state.  Before making cuts, the Legislature should:

• Maximize cost containment measured within Medicaid, such as introducing “never event” policies that prevent Medicaid paying for preventable health care delivery mistakes, and make sure the state’s Medicaid fraud prevention programs are as strong as possible.

• Prevent cost-shifting by considering new revenue sources.  Keeping Medicaid whole will prevent expensive cost-shifting to our small businesses and other purchasers of private insurance.  To avoid this, Utah should increase the tobacco tax rate by $2 and use the state’s $414 million rainy day fund to maintain current Medicaid eligibility and provider reimbursement rates.
  
  
• Reform the health care payment and delivery system—starting with Medicaid.